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Journal articles on the topic 'Anaesthetics'
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1
Baker, A. B. "Anaesthesia Workforce in Australia and New Zealand." Anaesthesia and Intensive Care 25, no. 1 (February 1997): 60–67. http://dx.doi.org/10.1177/0310057x9702500111.
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A survey of anaesthetic workforce was undertaken in departments in Australia and New Zealand approved for specialist training by the Australian and New Zealand College of Anaesthetists. When compared to a previous survey 17 years before, the results showed that the number of anaesthetics administered rose, the number of operating theatres (OTs) remained the same, but the surgical beds were reduced. There was a small increase (20%) in full-time specialists with a number of vacancies in establishment. There was, however, a large increase (80%) in Visiting Medical Officer (VMO) sessions and a 40% increase in Registrar positions. At the same time there were very large increases in Recovery Room nurses (125%) and Anaesthetic Assistants (100%). From this survey and other recent government workforce reports it is possible to derive certain workforce postulates—a specialist anaesthetist will on average anaesthetize approximately 1000 patients per annum, one in every nine people in the population will have an anaesthetic each year, and the working lifespan of a specialist anaesthetist is 30 years with 5% working half-time or less. All of this suggests that the correct Anaesthetists to Population Ratio (APR) should be reset to 1:8,500 for both Australia and New Zealand. The number of trainees required to supply a steady state replacement for this specialist workforce is also derived and the current number of training positions is shown to be in excess of these requirements. When the current shortfall in specialist anaesthetists is corrected there will need to be a gradual reduction (by approximately 40%) in the number of training positions to prevent an oversupply of anaesthetists. The factors which may potentially alter this forecast are addressed and include: change in the general population; ageing of the population; change in the average number of anaesthetics administered per anaesthetist per year; alteration in anaesthetists’ working lifespan; change in the age distribution of anaesthetists; increased economic usage of operating theatres and changes in the number of College approved training positions.
2
Patey, R., and RP Alston. "Anaesthesia and cardiopulmonary bypass: a UK and Ireland survey." Perfusion 8, no. 4 (July 1993): 313–19. http://dx.doi.org/10.1177/026765919300800406.
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A postal survey of consultant anaesthetists in the UK and Ireland was undertaken in the summer of 1989 to determine anaesthetic practice during cardiopulmonary bypass (CPB). A questionnaire requiring details of anaesthetic agents used for induction of anaesthesia, maintenance of anaesthesia before CPB and during CPB was sent to 198 consultants. There was a 52% response rate. Intravenous anaesthetics were used during induction of anaesthesia, maintenance of anaes thesia and during CPB by 100%, 64% and 81 % of respondents respectively. Opioids were used by 96%, 96% and 80%, volatile anaesthetics by 73%, 95% and 36%, and neuromuscular blockers by 100%, 97% and 90%. It is concluded that a balanced anaesthetic technique using neuromuscular blockers, opioids and intravenous anaesthetics is that which is most commonly used during CPB.
3
Cyna, A. M. "Anaesthesia in Rural Queensland: Clinical Experience with the Flying Obstetric and Gynaecology Service." Anaesthesia and Intensive Care 21, no. 6 (December 1993): 831–36. http://dx.doi.org/10.1177/0310057x9302100615.
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The Flying Obstetric and Gynaecology (FOG) service visits 27 outback towns scattered over approximately one million square kilometres of western Queensland. The role and workload of an anaesthetist attached to the FOG Service and a prospective audit of 760 consecutive anaesthetics over a ten-month period are reported. Flying anaesthetists are in an ideal position to review standards of equipment, staffing levels, anaesthetic assistance in theatre as well as participate in both medical and nursing rural training programs. This ensures that deficiencies in anaesthetic related areas are identified and appropriate action taken. The challenge to rural practitioners must be to provide a service, of at least an equivalent standard to that of their metropolitan counterparts.
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Cowan, David T. "The Impact of Culture on Anaesthetic Practice." British Journal of Anaesthetic and Recovery Nursing 5, no. 3 (August 2004): 47–51. http://dx.doi.org/10.1017/s1742645600001303.
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IN debating the issue of whether or not nursing care should be perceived within a framework of cultural competence, this paper briefly describes the background of this approach to nursing, and as an exemplar, discusses how culture can impact on the practice of anaesthetics and peri–anaesthetic care. This is illustrated through drawing on my own transcultural experiences while employed for nearly five years as a non–physician anaesthetist in Saudi Arabia and may therefore be of interest to those practitioners involved in the delivery of anaesthetics and peri–anaesthetic care.
5
Cowan, David. "From Anaesthetic Nurse to Nurse Anaesthetist: Is This Possible in the UK?" British Journal of Anaesthetic and Recovery Nursing 4, no. 3 (August 2003): 7–11. http://dx.doi.org/10.1017/s1742645600001029.
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Current practice in the United Kingdom (UK) dictates that the administration of a general anaesthetic is undertaken by a physician. However, for several years now the controversial question has been raised as to whether other practitioners, primarily nurse anaesthetists, should also be allowed administer general anaesthetics. The ensuing debate has been refueled in recent times resulting from the trend towards providing cost-effective health care delivery combined with concerns over current and anticipated further shortages in anaesthetic manpower. This paper discusses some of the arguments both for and against the introduction non-physician anaesthetists in the UK, also drawing on the debate in other parts of the world, concluding with a call for more research to address the controversy. First though, because there appears to be some confusion over the difference between the meaning of the titles ‘Anaesthetic Nurse’ and ‘Nurse Anaesthetist’, it will be helpful to provide brief definitions of these terms.
6
Phillips, G. D. "History: An Early Anaesthetic in Papua New Guinea." Anaesthesia and Intensive Care 25, no. 3 (June 1997): 286–88. http://dx.doi.org/10.1177/0310057x9702500315.
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A search for information about early anaesthetics administered in Papua New Guinea has revealed that an ether or chloroform anaesthetic was given, probably for a retained placenta, at Port Hunter on December 9, 1880. The anaesthetist or anaesthetic assistant was the Reverend George Brown, a Wesleyan Methodist missionary.
7
Perkins, Emma J., Daniel A. Edelman, and David J. Brewster. "Smartphone use and perceptions of their benefit and detriment within Australian anaesthetic practice." Anaesthesia and Intensive Care 48, no. 5 (September 2020): 366–72. http://dx.doi.org/10.1177/0310057x20947427.
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The primary aim of this study was to evaluate the perceptions of Australian anaesthetists in relation to smartphone use within anaesthetic practice. In particular, we aimed to assess the frequency of smartphone use, the types and number of smartphone applications used, how reliant anaesthetists perceive themselves to be on smartphones and whether they perceive them to be a factor that aids or distracts from their practice. Secondly, we assessed whether there is an association between the type, frequency, reliance and perceptions of smartphone use and the years of experience as an anaesthetist. A 24-item questionnaire addressing these questions was created and distributed to an email list of credentialled anaesthetists in Melbourne, Australia. A total of 113 consultant anaesthetists who practise at 55 hospitals in Melbourne completed the questionnaire. Our results suggest that the majority of anaesthetists are using smartphones regularly in their practice. About 74% of respondents agreed that they rely on their smartphone for their work. We found that respondents were more likely to rely on smartphones and consider them to aid patient safety than to consider them a distraction. This phenomenon was particularly apparent in those who had been a consultant anaesthetist for less than three years. Furthermore, those who had been a consultant anaesthetist for less than three years were more likely to have more smartphone apps relating to anaesthetics, use them more often and rely on them to a greater degree. Our results highlight the ubiquitous and perceived useful nature of smartphones in anaesthetic practice.
8
Franks, Nicholas P., William R. Lieb, and Srinivasa N. Raja. "Seeing the Light." Anesthesiology 101, no. 1 (July 1, 2004): 235–37. http://dx.doi.org/10.1097/00000542-200407000-00034.
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Most proteins are insensitive to the presence of general anaesthetics at concentrations which induce anaesthesia, while some are inhibited by some agents but not others. Here we show that, over a 100000-fold range of potencies, the activity of a pure soluble protein (firefly luciferase) can be inhibited by 50% at anaesthetic concentrations which are essentially identical to those which anaesthetize animals. This identity holds for inhalational agents (such as halothane, methoxyflurane and chloroform), aliphatic and aromatic alcohols, ketones, ethers and alkanes. This finding is all the more striking in view of the fact that the inhibition is shown to be competitive in nature, with anaesthetic molecules competing with the substrate (luciferin) molecules for binding to the protein. We show that the anaesthetic-binding site can accommodate only one large, but more than one small, anaesthetic molecule. The obvious mechanism suggested by our results is that general anaesthetics, despite their chemical and structural diversity, act by competing with endogenous ligands for binding to specific receptors.
9
Jeanes, A., J. Dick, P. Coen, N. Drey, and DJ Gould. "Hand hygiene compliance monitoring in anaesthetics: Feasibility and validity." Journal of Infection Prevention 19, no. 3 (February 16, 2018): 116–22. http://dx.doi.org/10.1177/1757177418755306.
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Background: Hand hygiene compliance scores in the anaesthetic department of an acute NHS hospital were persistently low. Aims: To determine the feasibility and validity of regular accurate measurement of HHC in anaesthetics and understand the context of care delivery, barriers and opportunities to improve compliance. Methods: The hand hygiene compliance of one anaesthetist was observed and noted by a senior infection control practitioner (ICP). This was compared to the World Health Organization five moments of hand hygiene and the organisation hand hygiene tool. Findings: In one sequence of 55 min, there were approximately 58 hand hygiene opportunities. The hand hygiene compliance rate was 16%. The frequency and speed of actions in certain periods of care delivery made compliance measurement difficult and potentially unreliable. During several activities, taking time to apply alcohol gel or wash hands would have put the patients at significant risk. Discussion: We concluded that hand hygiene compliance monitoring by direct observation was invalid and unreliable in this specialty. It is important that hand hygiene compliance is optimal in anaesthetics particularly before patient contact. Interventions which reduce environmental and patient contamination, such as cleaning the patient and environment, could ensure anaesthetists encounter fewer micro-organisms in this specialty.
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Inoue, Luis Antônio Kioshi Aoki, Cristiano dos Santos Neto, and Gilberto Moraes. "Clove oil as anaesthetic for juveniles of matrinxã Brycon cephalus (Gunther, 1869)." Ciência Rural 33, no. 5 (October 2003): 943–47. http://dx.doi.org/10.1590/s0103-84782003000500023.
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Many chemicals have been used as anaesthetics in fish farms and fish biology laboratories to keep the fish immobilized during handling procedures and to prevent accidents and animal stress. In Brazil, tricaine methane sulfonate (MS 222), quinaldine sulfate, benzocaine, and phenoxyethanol are the most common fish anaesthetics used to prevent fish stress during handling, but many side effects such as body and gill irritations, corneal damage and general risks of intoxication have been reported. Clove oil is a natural product proposed as an alternative fish anaesthetic by many researchers and it has been used in many countries with great economic advantages and no apparent toxic properties. In this work, we assessed the suitability of clove oil to anaesthetize matrinxã. Sixty-three juveniles of matrinxã were exposed to seven anaesthetic batches of clove oil (pharmaceutical grade) namely 18, 20, 30, 40, 50, 60, and 70 mg/L. The times to reach total loss of equilibrium and to recover the upright position were measured. Clove oil concentration about 40 mg/L was enough to anaesthetize the fish in approximately one minute and the recovery time was independent in regard to anaesthetic concentration.
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Mather, Laurence E., and Geoffrey T. Tucker. "When Regional Anesthesia Met Pharmacokinetics." Anesthesiology 136, no. 4 (February 16, 2022): 588–93. http://dx.doi.org/10.1097/aln.0000000000004143.
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Pharmacokinetics of Local Anaesthetic Agents. By Tucker GT, Mather LE. Br J Anaesth 1975; 47(suppl 1):213–24 Information derived from measurements of blood concentrations of local anaesthetics can be extended by the application of pharmacokinetic analysis. A better understanding of quantitative aspects of the disposition and absorption of these drugs should assist the anaesthetist in deciding the optimal agent and dosage for regional block techniques.
12
Bogari, Ahmed Fouad, Ibrahim Abdulkareem Aldakhil, Maram Fahad Alsuwaidan, Nawaf Meshal Alhassani, Dhari Ali Alroudan, Omar Eid Aljuaid, Mohammed Ali Alqarni, et al. "Inhalation anaesthetics: types, mechanism of action and adverse effects." International Journal Of Community Medicine And Public Health 9, no. 12 (November 28, 2022): 4684. http://dx.doi.org/10.18203/2394-6040.ijcmph20223230.
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Inhalational anesthetics have been used to induce and maintain general anaesthesia for more than 150 years. These anaesthetic agents are commonly used in the surgical and clinical practice solely and as a conjugant with other anaesthetics. Since inhalational anaesthetic agents develop amnesia, loss of awareness, and reduce reactions to painful surgical stimuli, they are an essential part of general anaesthesia. The choice of anaesthetic agent is based on the procedure's duration and type, patient characteristics, the attending anaesthesiologist’s preferences, and occasionally on institutional protocols. These medications are administered to the patient through the anesthetic circuit using a special vaporizer. The purpose of this research is to review the available information about inhalation anaesthetics: types, mechanism of action and adverse effects. Nitrous oxide is one of the earliest anaesthetic agents while isoflurane, sevoflurane, and desflurane are three commonly used inhalational anaesthetics. The low-solubility inhalation anaesthetics desflurane and sevoflurane have several clinical advantages over isoflurane, including rapid induction and faster recovery after prolonged treatment. However, isoflurane can sometimes be used effectively enough to match the induction and recovery times of other drugs. Inhalation anaesthetics work by suppressing inhibitory signals such as chloride channels and potassium channels and enhancing excitatory signals such as acetylcholine, muscarinic and nicotinic receptors, glutamate and serotonin in the central nervous system. Certain side effects including nausea, vomiting, malignant hyperthermia, post-operative cognitive impairment is associated with their use. More research is needed to further enhance the safety profile of available inhalation anaesthetics and can further lead to discovery of new, safe anaesthetics.
13
Fisher, M. McD, and C. J. Bowey. "Alleged Allergy to Local Anaesthetics." Anaesthesia and Intensive Care 25, no. 6 (December 1997): 611–14. http://dx.doi.org/10.1177/0310057x9702500602.
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The aim of this study was to determine the incidence of true local anaesthetic allergy in patients with an alleged history of local anaesthetic allergy and whether subsequent exposure to local anaesthetics is safe. Two hundred and eight patients with a history of allergy to local anaesthesia were referred over a twenty-year period to our Anaesthetic Allergy Clinic. In this open study, intradermal testing was performed in three patients and progressive challenge in 202 patients. Four patients had immediate allergy and four patients delayed allergic reactions. One hundred and ninety-seven patients were not allergic to local anaesthetics. In 39 patients an adverse response to additives in local anaesthetic solutions could not be excluded. In all but one patient local anaesthesia has been given uneventfully subsequently. A history of allergy to local anaesthesia is unlikely to be genuine and local anaesthetic allergy is rare. In most instances LA allergy can be excluded from the history and the safety of LA verified by progressive challenge.
14
Shipton, Edward A. "New Delivery Systems for Local Anaesthetics—Part 2." Anesthesiology Research and Practice 2012 (2012): 1–6. http://dx.doi.org/10.1155/2012/289373.
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Part 2 of this paper deals with the techniques for drug delivery of topical and injectable local anaesthetics. The various routes of local anaesthetic delivery (epidural, peripheral, wound catheters, intra-nasal, intra-vesical, intra-articular, intra-osseous) are explored. To enhance transdermal local anaesthetic permeation, additional methods to the use of an eutectic mixture of local anaesthetics and the use of controlled heat can be used. These methods include iontophoresis, electroporation, sonophoresis, and magnetophoresis. The potential clinical uses of topical local anaesthetics are elucidated. Iontophoresis, the active transportation of a drug into the skin using a constant low-voltage direct current is discussed. It is desirable to prolong local anaesthetic blockade by extending its sensory component only. The optimal release and safety of the encapsulated local anaesthetic agents still need to be determined. The use of different delivery systems should provide the clinician with both an extended range and choice in the degree of prolongation of action of each agent.
15
K.G, Bhavya, and George M. J. "ĀKĀRAKARA AS DERMAL ANAESTHETIC." International Ayurvedic Medical Journal 9, no. 11 (November 15, 2021): 2764–68. http://dx.doi.org/10.46607/iamj1909112021.
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Nowadays, the role of local anaesthesia in the surgical field is highly appraisable. Local anaesthetics are the drugs that produce a loss of sensation over the localised areas without producing a loss of consciousness. Humans have been using various methods to block pain for thousands of years. Controlling pain during the śhastrakarma in śalyatantra has been always challenging. There has been the introduction of various methods of local anaesthetics since the origin of medical science, topical anaesthetics being one of them. Studies have been conducted to discover novel anaesthetic agents by various scholars. Herbal extracts do not stand far in the pathway of this search. Owing to these discoveries, 30% ethanolic extract gel of Ākārakara (Spilanthes calva DC.) is selected here as a topical anaesthetic to evaluate the efficacy in facilitating the management of warts by a painful procedure agnikarma. Keywords: Dermal anaesthetic, Ākārakara, Spilanthol
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Ghantous, Hanan N., Jeanne Fernando, Scott E. Morgan, A. Jay Gandolfi, and Klaus Brandel. "Precision-cut Guinea-pig Liver Slices as a Tool for Studying the Toxicity of Volatile Anaesthetics." Alternatives to Laboratory Animals 18, no. 1_part_1 (November 1990): 191–99. http://dx.doi.org/10.1177/026119299001800120.1.
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Cultured precision-cut liver slices retain normal liver architecture and physiological biochemical functions. Hartley male guinea-pig liver slices have proven to be a good model for studying the biotransformation and toxicity of halothane. This system was used to evaluate the biotransformation and toxicity of different volatile anaesthetics (halothane, enflurane, isoflurane and sevoflurane), and compare their effects to those of new anaesthetics (desflurane). Liver slices (250–300μm thick) were incubated in sealed roller vials, containing Krebs Henseleit buffer at 37°C under 95% O2:5% CO2 atmosphere. Volatile anaesthetics were delivered by volatilisation after pre-incubation for 1 hour to produce a constant concentration in the medium. Production of the metabolites, trifluroacetic acid and fluoride ion, was measured. Intracellular potassium ion content, protein synthesis and secretion were determined as indicators of viability of the slices. The rank order of biotransformation of anaesthetics by the liver slices was halothane >sevoflurane>isoflurane and enflurane>desflurane. The rank order of hepatotoxicity of these anaesthetics was halothane>isoflurane and enflurane>sevoflurane and desflurane. Halothane is the anaesthetic which is metabolised furthest and has the most toxic effect, while desflurane is the least metabolised anaesthetic and has the least toxicity. This in vitro cultured precision-cut liver slice system appears to be suitable for studying the biotransformation of volatile anaesthetics and correlating its role in the resulting toxicity.
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Sims, C., B. Stanley, and E. Milne. "The Frequency of and Indications for General Anaesthesia in Children in Western Australia 2002–2003." Anaesthesia and Intensive Care 33, no. 5 (October 2005): 623–28. http://dx.doi.org/10.1177/0310057x0503300512.
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We conducted a retrospective database search of the Hospital Morbidity Data System at the Health Department of Western Australia to determine the number of anaesthetics given to children aged 16 years or less in Western Australia over a twelve-month period. Information was also collected to assess the types of surgery for which anaesthesia was being provided, and the categories of hospital in which children were being anaesthetized. We found that 28,522 anaesthetics were given to 24,981 children, and 2,462 (9.9%) children had more than one anaesthetic. Five and a half percent of the children in Western Australia had an anaesthetic during the twelve months studied. The most common types of surgery were ear nose and throat (28% of anaesthetics), general (21%), dental/oral procedures (17%) and orthopaedic (15%). There was a bimodal distribution in the incidence of anaesthesia versus age, with peaks at 4 years and at 16 years. The most common category of hospital that children were anaesthetized in was private metropolitan (40%) followed by tertiary (38%), rural (14%) and public metropolitan (8%). One thousand, seven hundred and seven children aged less than one year were given an anaesthetic. These anaesthetics were most frequently given to children in tertiary hospitals (62%) followed by private metropolitan (30%), public metropolitan (6%) and rural hospitals (2%).
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Pasternak, Marcin, and Jarosław Woroń. "The role of local anaesthesia in intra-operative pain management in dental practice." BÓL 22, no. 1 (May 27, 2021): 24–35. http://dx.doi.org/10.5604/01.3001.0014.9018.
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Intra-operative pain management with the means of local anaesthesia is an important of dental practice. Local anaesthetics are drugs the most commonly used drugs in dentistry, being, at the same time, the safest and most effective pain preventing and pain relieving agents known to medicine.The mechanism of action of local anaesthetics involves interruption of the conduction of nerve impulses. These agents show high affinity for the voltage-dependent sodium channels (Nav), they block them, thus preventing the influx of sodium cations through the membranes of the neuron. The potential threshold is not reached and the potential itself is not present. The potency of local anaesthetic drugs depends primarily on the concentration of the solutions used, while possible side effects depend on the dose. In this paper the characteristics of local anaesthetics used in dental practice were presented as well as characteristics of vasoconstrictors added to anaesthetic solutions. The historical outline, the mechanism of action of local anaesthetics and the currently used both basic and additional methods of anaesthesia are discussed. Possible strategies for improving the effectiveness of anaesthesia by the means of physical and chemical methods were explained. General and local adverse reactions of dental anaesthetics were also discussed, along with ways to prevent and treat them.
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Neuwersch, S., M. Köstenberger, S. Sorschag, W. Ilias, and R. Likar. "Antimicrobial Activity of Lidocaine, Bupivacaine, Mepivacaine and Ropivacaine on Staphylococcus epidermidis, Staphylococcus aureus and Bacillus subtilis." Open Pain Journal 10, no. 1 (February 28, 2017): 1–4. http://dx.doi.org/10.2174/1876386301710010001.
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Introduction: Various studies have shown a possible antimicrobial activity of different local anaesthetics, which may affect the results of microbial assessment of biopsies. The purpose of this study was to test the antimicrobial activity of different commonly used anaesthetic agents on Staphylococcus epidermidis, Staphylococcus aureus and Bacillus subtitles to reproduce data and to compare the findings. Methods: Local anaesthetics tested were commercially available solutions of lidocaine (Xyloneural®, Xylanaest pur.®), bupivacaine (Bucain®), mepivacaine (Mecain®) and ropivacaine (Naropin®, Ropinaest®).2%, 1%, 0.5%, 0.25% and 0.1% (20, 10, 5, 2.5, 1 mg/ml) dilutions of these local anaesthetics were prepared with sterile 0.9% saline. Bacteria used in this study were Staphylococcus epidermidis, Staphylococcus aureus and Bacillus subtilis. 10 μl of different local anaesthetic dilution placed on thin wafers were added to Mueller Hinton Agar and cultured. After 24 hours, a zone of inhibition around the wafers was evaluated. Results: Local anaesthetics in different concentrations did not show any zone of inhibition on Staphylococcus epidermidis, Staphylococcus aureus or Bacillus subtilis. Conclusion: In summary, neither lidocaine, bupivacaine, mepivacaine nor ropivacaine showed an antibacterial effect on Staphylococcus epidermidis, Staphylococcus aureus and Bacillus subtilis. Implications: Due to these findings this local anaesthetics can be used in daily clinical routine to perform pain free diagnostic procedures in which culture specimens are to be obtained. Due to inconsistent results in prior studies, we recommend to use the lowest concentration possible of the local anaesthetic, also to avoid other possible side effects of local agents.
20
Bozkurt, G., D. Memis, G. Karabogaz, Z. Pamukcu, M. Ture, B. Karamanlioglu, I. Gunday, and C. Algunes. "Genotoxicity of Waste Anaesthetic Gases." Anaesthesia and Intensive Care 30, no. 5 (October 2002): 597–602. http://dx.doi.org/10.1177/0310057x0203000509.
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Background and aim: The possibility of a potential mutagenic or carcinogenic action of chronic exposure to low concentrations of inhalational anaesthetics has been previously studied, with conflicting results. The purpose of this study was to assess whether occupational exposure to waste anaesthetic gases increases genotoxic risk. We examined peripheral lymphocytes from anaesthetists for both sister chromatid exchange (SCE) and for cells with high-frequency SCEs (HFCs). Method: A group of 16 non-smoking anaesthetists with occupational exposure to anaesthetic gases and a sex- and age-matched group matched 16 non-smoking matched physicians without occupational exposure to anaesthetic gases were studied. The participants were also selected on the basis of similar responses to a questionnaire assessing risk of genotoxicity relating to other aspects of life. Result: SCEs, and HFC percentages obtained from the exposed anaesthetists (6.6±2.4 and 12.2±15.9) were greater but not statistically significantly so than in the reference group (5.2±1.6 and 5.9±10.0). Conclusion: This study does not support the existence of an association between occupational exposure to waste anaesthetic gases and an increase in SCEs in lymphocytes. The nature of our anaesthesia practice suggests exposure was likely to be low. It should be noted that some anaesthetic gases produce lesions that can be efficiently repaired in mitogen-stimulated lymphocytes in vitro but not in circulating lymphocytes.
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Mcnally, Sj, M. Mackinnon, and M. Hawkins. "Practical Barriers to the Implementation of Early Goal Directed Therapy in the UK: Trainee Skills and Awareness." Scottish Medical Journal 54, no. 3 (August 2009): 22–24. http://dx.doi.org/10.1258/rsmsmj.54.3.22.
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The Surviving Sepsis Campaign (SSC) recommends Early Goal Directed Therapy (EGDT) in the treatment of septic shock, which requires key critical care skills and knowledge. This study evaluates the availability of these skills in Specialist Registrars in acute hospital specialities in the UK. A questionnaire was sent to Specialist Registrars in Anaesthetics, General Surgery and General Medicine throughout Scotland. One hundred and eighty five responses were obtained. One hundred percent of anaesthetists, 70% of surgeons and 51% of physicians were aware of EGDT. Only 62 trainees (6% of surgeons, 79% of anaesthetists, 19% of physicians) had the full complement of skills and knowledge to implement EGDT. This study demonstrates that non-anaesthetic registrars in the UK lack both knowledge and skills required to provide EGDT. The main deficit was in awareness, demonstrating that knowledge of EGDT is not penetrating into specialities beyond anaesthesia. It is now time for the SSC to specifically target non-anaesthetic specialities.
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Callear, A. B. "The Effect of Temperature on the Discomfort Caused by Topical Local Anaesthesia." Journal of the Royal Society of Medicine 88, no. 12 (December 1995): 709P—711P. http://dx.doi.org/10.1177/014107689508801221.
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The warming of local anaesthetic solutions to reduce the pain felt on injection is common practice in a number of medical sub-specialties. A study was undertaken to assess the effect of temperature on the discomfort caused by local anaesthetic eye drops. Tropical anaesthetics amethocaine 1%, oxybuprocaine 0.4% and lignocaine 4% were studied, and after the application of strict exclusion criteria 60 patients were selected, 20 patients for each anaesthetic. Each patient group received a topical anaesthetic at 42 C in one eye and at room temperature in the other. A 10 point visual analogue scale was used to assess the discomfort experienced. No statistically significant difference was found between the discomfort caused by drops at each temperature for any of the three anaesthetics studied. There appears no benefit in warming topical anaesthetic agents prior to their use.
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Plummer, J. L., I. M. Steven, and M. J. Cousins. "Metabolism of Halothane in Children Having Repeated Halothane Anaesthetics." Anaesthesia and Intensive Care 15, no. 2 (May 1987): 136–40. http://dx.doi.org/10.1177/0310057x8701500203.
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Metabolism of halothane was studied in nine children receiving daily halothane anaesthetics (from 10 up to a maximum of 31) over periods of two to seven weeks. Serum bromide concentrations never exceeded 3.5 mmol/l, a concentration below the toxic threshold. Repeated halothane anaesthetics at short intervals did not induce the reductive metabolism of halothane as assessed by 2-chloro-1,1,1-trifluoroethane (CTF) in the expired breath. One patient developed viral hepatitis A during the course of anaesthetic administration; this patient was the only one whose serum bromide concentrations fell substantially and whose exhaled CTF concentration increased as more anaesthetics were administered.
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Ouro-Bang'na Maman, A. F., K. Tomta, S. Ahouangbévi, and M. Chobli. "Deaths associated with anaesthesia in Togo, West Africa." Tropical Doctor 35, no. 4 (October 1, 2005): 220–22. http://dx.doi.org/10.1258/004947505774938666.
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This study attempts to determine the anaesthetic death rate, the causes of deaths and the avoidable mortality rate (AMR) in consecutive cases. The number of anaesthetics given was 1464: 30 cases died within 24 h. The incidence of 24-h perioperative deaths per 100 anaesthetics was 2.57. In all, 50% of deaths were observed in obstetric surgery; 47% of deaths were associated with cardiovascular management, 30% with respiratory management; 93% of deaths were identified as avoidable. The AMR was 1.5% (anaesthetic AMR: 0.75%, administrative AMR: 0.68%, surgical AMR: 0.07%). Insufficient or no blood available is the only factor for administrative AMR.
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DeFord, Stephanie, Julie Bonom, and Terri Durbin. "A review of literature on substance abuse among anaesthesia providers." Journal of Research in Nursing 24, no. 8 (March 22, 2019): 587–600. http://dx.doi.org/10.1177/1744987119827353.
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Background Research has demonstrated that anaesthesia providers are susceptible to substance abuse. Several preventive measures are being implemented in certified registered nurse anaesthetist programmes to educate future providers about substance abuse. Given the continued prevalence and impact of the problem, more research is needed about the prevalence of substance abuse among student registered nurse anaesthetists and the implementation of preventive strategies in the educational setting. Aims The purpose of this narrative literature review was to examine the state of the science related to substance abuse among US certified anaesthesia providers. This literature review covered abuse of alcohol, tobacco, recreational drugs, opioids and anaesthetic agents. Methods This narrative review was conducted using the following search terms: anaesthesia, student, wellness, stress, substance abuse, satisfaction, personality, depression, nurse, nurse anaesthetist, propofol, isoflurane and fentanyl. References were identified using PubMed, CINAHL, Google Scholar, and the American Society of Anesthesiologists and American Association of Nurse Anesthetists websites. A total of 36 articles were identified as relevant to this literature review based on content and country of publication. This literature review was limited to articles published in the past 15 years. With one exception, our search was limited to manuscripts from the US. Results The literature underscored that various risk factors contribute to substance abuse. Board-certified anaesthesia providers fall prey to substance abuse due to ease of access, the high stress associated with administering anaesthesia, and the propensity to become addicted to opioids and other anaesthetics. A gap in the science exists about the prevalence of substance abuse among student registered nurse anaesthetists and the effectiveness of preventive strategies in the educational setting. Conclusions Anaesthesia providers are at high risk of abusing substances. To create a safer environment, future research should explore the prevalence of substance abuse among student registered nurse anaesthetists and emphasise the integration of effective preventive strategies in the educational setting.
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Adams, Aileen K. "The Delayed Arrival: From Davy (1800) to Morton (1846)." Journal of the Royal Society of Medicine 89, no. 2 (February 1996): 96P—100P. http://dx.doi.org/10.1177/014107689608900214.
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Dr Adams was previously consultant anaesthetist to Addenbrooke's Hospital, Cambridge, with a special interest in ophthalmic and neuroanaesthesia, and Associate Lecturer in Cambridge University. She was Dean of the Faculty of Anaesthetists of the Royal College of Surgeons of England in 1985, now the Royal College of Anaesthetists, of which she is currently Honorary Archivist/Curator. She was Hunterian Professor in the Royal College of Surgeons in 1993, and is a past president of the History of Anaesthesia Society. Within the RSM she was president of the Section of Anaesthetics in 1985-1986 and of the Section of the History of Medicine in 1994-1995, having served as Honorary Secretary of each. She is now an Honorary Treasurer of the Society.
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Vempaty, Srikrishna, and James Robbins. "Self-Inflicted Trauma Secondary to Local Anaesthesia in Children." Case Reports in Dentistry 2017 (2017): 1–2. http://dx.doi.org/10.1155/2017/4969484.
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Long acting local anaesthetics and inferior alveolar nerve block in children can cause loss of sensation and proprioception in a large area supplied by that particular nerve. Similar to the maxilla in mandible also, adequate level of anaesthesia can be achieved in the desired site of treatment by using a short acting local anaesthetic. Early return of normal sensory feedback after using short acting anaesthetics can be helpful in preventing self-harm.
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Lee, Ki-Hwan, Alan R. McIntosh, and François Boucher. "The interaction between halogenated anaesthetics and bacteriorhodopsin in purple membranes as examined by intrinsic ultraviolet fluorescence." Biochemistry and Cell Biology 69, no. 2-3 (February 1, 1991): 178–84. http://dx.doi.org/10.1139/o91-026.
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In the presence of halogenated general anaesthetics such as enflurane and halothane, the spectral properties of the bacteriorhodopsin pigment contained in the purple membranes of Halobacterium halobium are strongly modified. It is reversibly transformed into a red-coloured species absorbing maximally at 480 nm, at the expense of its characteristic 570-nm absorption band. The ultraviolet fluorescence of bacteriorhodopsin has been used to probe the structural modifications that are reflected by this spectral change. Our results show that they are very small and do not perturb the energy transfer dynamics which take place between the aromatic amino acid residues and the retinyl chromophore. The fluorescence properties of anaesthetic-treated bacteriorhodopsin are dominated by the quenching properties of the halogenated hydrocarbon, which are obvious even at anaesthetic concentrations under those needed to induce a spectral change in the bacteriorhodopsin chromophore. This does not rule out direct interaction between anaesthetics and bacteriorhodopsin, but it indicates that the chromophoric site might well not be their primary target.Key words: purple membranes, bacteriorhodopsin, anaesthetics, fluorescence, quenching.
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McGain, Forbes, Jason R. Bishop, Laura M. Elliot-Jones, David A. Story, and Georgina LL Imberger. "A survey of the choice of general anaesthetic agents in Australia and New Zealand." Anaesthesia and Intensive Care 47, no. 3 (May 2019): 235–41. http://dx.doi.org/10.1177/0310057x19836104.
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Strategies to reduce the adverse environmental costs of anaesthesia include choice of agent and fresh gas flows. The current preferences of Australian and New Zealand anaesthetists are unknown. We conducted a survey of Australian and New Zealand anaesthetists to determine the use of volatiles, nitrous oxide and intravenous anaesthesia, lowest fresh gas flow rates, automated end-tidal volatile control, and the rationales for these choices. The survey was answered by 359/1000 (36%), although not all questions and multiple responses within single questions were answered by all respondents. Sevoflurane was preferred by 246/342 (72%, 95% confidence interval (CI) 67%–77%), followed by propofol, 54/340 (16%, 95% CI 12%–20%), desflurane 39/339 (12%, 95% CI 8%–16%) and isoflurane 3/338(1%, 95% CI 0–3%). When asked about all anaesthetics, low-risk clinical profile was the most common reason given for using sevoflurane (129/301 (43%, 95% CI 37%–49%)), reduced postoperative nausea for propofol (297/318 (93%, 95% CI 90%–96%)) and faster induction/awakening times for desflurane (46/313 (79%, 95% CI 74%–83%)). Two-thirds (226/340 (66%, 95% CI 61%–71%)) of respondents used nitrous oxide in 0–20% of general anaesthetics. Low fresh gas flow rates for sevoflurane were used by 310/333 (93%, 95% CI 90%–95%) and for 262/268 (98%, 95% CI 95%–99%) for desflurane. Automated end-tidal control was used by 196/333 (59%, 95% CI 53%–64%). The majority of respondents (>70%) preferred sevoflurane at low flows. These data allow anaesthetists to consider further whether changes are required to the choices of anaesthetic agents for environmental, financial, or any other reasons.
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&NA;. "General anaesthetics/local anaesthetics." Reactions Weekly &NA;, no. 1214 (August 2008): 17–18. http://dx.doi.org/10.2165/00128415-200812140-00048.
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&NA;. "Anaesthetics see Analgesics/anaesthetics." Reactions Weekly &NA;, no. 318 (September 1990): 4. http://dx.doi.org/10.2165/00128415-199003180-00009.
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Debel, Wiebrecht, Ali Ramadhan, Caroline Vanpeteghem, and Ramses G. Forsyth. "Does the Choice of Anaesthesia Affect Cancer? A Molecular Crosstalk between Theory and Practice." Cancers 15, no. 1 (December 29, 2022): 209. http://dx.doi.org/10.3390/cancers15010209.
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In recent years, there has been an increasing scientific interest in the interaction between anaesthesia and cancer development. Retrospective studies show that the choice of anaesthetics may influence cancer outcome and cancer recurrence; however, these studies show contradictory results. Recently, some large randomized clinical trials have been completed, yet they show no significant effect of anaesthetics on cancer outcomes. In this scoping review, we compiled a body of in vivo and in vitro studies with the goal of evaluating the biological effects of anaesthetics on cancer cells in comparison to clinical effects as described in recent studies. It was found that sevoflurane, propofol, opioids and lidocaine are likely to display direct biological effects on cancer cells; however, significant effects are only found in studies with exposure to high concentrations of anaesthetics and/or during longer exposure times. When compared to clinical data, these differences in exposure and dose–effect relation, as well as tissue selectivity, population selection and unclear anaesthetic dosing protocols might explain the lack of outcome.
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Hu, Z. Y., and J. Liu. "Mechanism of Cardiac Preconditioning with Volatile Anaesthetics." Anaesthesia and Intensive Care 37, no. 4 (July 2009): 532–38. http://dx.doi.org/10.1177/0310057x0903700402.
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In recent years, there has been increased interest in the mechanisms involved in anaesthetic-induced cardioprotection. It is not thoroughly understood how volatile anaesthetics protect the myocardium from ischaemia or reperfusion injury, but the overall mechanism is likely to be multifactorial. This review examines the recent experimental and clinical research underlying the cellular and molecular mechanisms involved in anaesthetic-induced preconditioning. A variety of intracellular signalling pathways have been implicated in the protective phenomenon. Ischaemic preconditioning and anaesthetic-induced preconditioning share similar molecular mechanisms, including activation of guanine nucleotide-binding proteins, triggering of second messenger pathways, activation of multiple kinases, mediation of nitric oxide formation and reactive oxygen species release, maintenance of intracellular and/or mitochondrial Ca2+ homeostasis and moderation of the opening of adenosine-triphosphate-sensitive potassium channels. A more thorough understanding of the multiple signalling steps and the ultimate cytoprotective mechanisms underlying anaesthetic-induced preconditioning may lead to improvements in the management of ischaemia and/or reperfusion injury.
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Türkan, Hülya, Ahmet Aydin, Ahmet Sayal, Ayşe Eken, Cemal Akay, and Bensu Karahalil. "Oxidative and Antioxidative Effects of Desflurane and Sevoflurane on Rat Tissue in Vivo." Archives of Industrial Hygiene and Toxicology 62, no. 2 (June 1, 2011): 113–19. http://dx.doi.org/10.2478/10004-1254-62-2011-2096.
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Oxidative and Antioxidative Effects of Desflurane and Sevoflurane on Rat Tissuein VivoGeneral anaesthetics are often used in patients who are under oxidative stress due to a critical illness or surgical trauma. Some anaesthetics may worsen oxidative stress and some may act as antioxidants. The aim of this study was to evaluate liver, brain, kidney, and lung tissue oxidative stress in rats exposed to desflurane and sevoflurane and in unexposed rats. The animals were divided in three groups: control (received only air); sevoflurane (8 %), and desflurane (4 %). After four hours of exposure, we evaluated the levels of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), Cu, and Zn. Exposure to either of the anaesthetics significantly increased lung MDA levels compared to control (Mann-Whitney U test; P<0.05), probably because it is the tissue directly exposed to anaesthetic gases. Oxidative stress and antioxidant activity in other tissues varied between the desflurane and sevoflurane groups. Our results suggest that anaesthesiologist should not only be aware of the oxidative or antioxidative potential of anaesthetics they use, but should also base their choices on organs which are the most affected by their oxidative action.
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&NA;. "Alfentanil/general anaesthetics/local anaesthetics." Reactions Weekly &NA;, no. 1283 (January 2010): 10. http://dx.doi.org/10.2165/00128415-201012830-00035.
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Grebenchikov, O. A., Yu V. Skripkin, O. N. Gerasimenko, K. K. Kadantseva, A. L. Bachinskiy, L. B. Berikashvili, and V. V. Likhvantsev. "Non-anaesthetic effects of modern halogen-containing anaesthetics." Patologiya krovoobrashcheniya i kardiokhirurgiya 24, no. 2 (July 3, 2020): 26. http://dx.doi.org/10.21688/1681-3472-2020-2-26-45.
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<p>Many patients undergo surgery under general anaesthesia each day. One of the high-priority tasks for an anesthesiologist is to protect tissues from a systemic inflammatory reaction or oxidative distress (including ischaemia/reperfusion). This review aims to demonstrate the anti-inflammatory and antioxidant properties of general anaesthesia in experimental and clinical studies.<br />Halogenated anaesthetics lead to the inactivation of glycogen synthase kinase-3β (GSK-3β), a key enzyme in the implementation of cellular damage mechanisms and systemic inflammatory response syndrome (SIRS). These mechanisms are implemented through the transcription factor nuclear factor (NF)-κB. As a result of NF-κB activation, gene expression responsible for proinflammatory cytokine synthesis follows, activating leukocytes and disrupts endothelial cell junctions, leading to a disruption of the endothelial barrier, leukocyte infiltration into tissues, and the development of SIRS. Furthermore, GSK-3β phosphorylation causes an increase in the level in neuronal cells and hepatocytes of transcription factor Nrf2, which is a master regulator of enzyme levels of antioxidant defence in the cell.<br />Thus, halogenated anaesthetics interfere with different elements responsible for the implementation of SIRS and oxidative distress in addition to limiting disturbing factors during the development of multiorgan failure and endothelial dysfunction in experimental sepsis and a model of ischaemia/reperfusion. Understanding these processes can help to reduce many complications during the post-operative period.</p><p>Received 9 January 2020. Revised 6 April 2020. Accepted 7 April 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and study design: O.A. Grebenchikov, Y.V. Skripkin, V.V. Likhvantsev <br />Drafting the article: O.A. Grebenchikov, Y.V. Skripkin, O.N. Gerasimenko, K.K. Kadantseva, A.L. Bachinskiy, L.B. Berikashvili, <br />V.V. Likhvantsev <br />Critical revision of the article: О.А. Grebenchikov, K.K. Kadantseva <br />Final approval of the version to be published: O.A. Grebenchikov, Y.V. Skripkin, O.N. Gerasimenko, K.K. Kadantseva, <br />A.L. Bachinskiy, L.B. Berikashvili, V.V. Likhvantsev</p>
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LIU, Renyu, Jinsheng YANG, Chung-Eun HA, Nadhipuram V. BHAGAVAN, and Roderic G. ECKENHOFF. "Truncated human serum albumin retains general anaesthetic binding activity." Biochemical Journal 388, no. 1 (May 10, 2005): 39–45. http://dx.doi.org/10.1042/bj20041224.
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Multiple binding sites for anaesthetics in HSA (human serum albumin) make solution studies difficult to interpret. In the present study, we expressed the wild-type HSA domain 3 (wtHSAd3), a peptide with two known anaesthetic binding sites in a yeast expression system. We also expressed a site-directed mutant of domain 3 (Y411Wd3). The stability and secondary structure of the constructed fragments were determined by HX (hydrogen–tritium exchange) and CD spectroscopy. The binding of two general anaesthetics, 2-bromo-2-chloro-1,1,1-trifluoroethane and propofol, to wtHSAd3 and Y411Wd3 was determined using isothermal titration calorimetry, HX and intrinsic tryptophan fluorescence quenching. Although the expressed fragments are less stable than intact wtHSA as indicated by both CD and HX, they retain the secondary structure and anaesthetic-binding characteristics of an intact HSA molecule, but with fewer binding sites. Y411Wd3 had decreased affinity for propofol but not for 2-bromo-2-chloro-1,1,1-trifluoroethane, consistent with steric hindrance. Retention of structural features and anaesthetic binding properties with fewer binding sites in this truncated protein provide feasibility for using scaled-down models of otherwise intractable systems to gain an understanding of anaesthetic binding requirements and binding–stability relationships.
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Frei, D., K. M. Stowell, E. E. Langton, L. McRedmond, N. A. Pollock, and T. F. Bulger. "Administration of Anaesthetic Triggering Agents to Patients Tested Malignant Hyperthermia Normal and Their Relatives in New Zealand: An Update." Anaesthesia and Intensive Care 45, no. 5 (September 2017): 611–18. http://dx.doi.org/10.1177/0310057x1704500512.
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Testing for malignant hyperthermia in New Zealand involves two tests—in vitro contracture testing of excised lateral quadriceps muscle and DNA analysis. In vitro contracture testing is regarded as the gold standard in malignant hyperthermia diagnosis but several publications have questioned the reliability of a normal result. Analysis of 479 anaesthetic records in 280 patients or their descendants throughout New Zealand who had tested negative for malignant hyperthermia, demonstrated there was no evidence of malignant hyperthermia episodes in this group who had been administered anaesthetic triggering agents. A wide range of anaesthetics were used over the study period. Analysis of each anaesthetic record was undertaken using the malignant hyperthermia grading scale which determines the likelihood that an anaesthetic event represents a malignant hyperthermia episode. Confirmation of the negative results was further supported by normal DNA analysis of patients in 48% of anaesthetics. There are advantages to using inhalational agents in certain situations and although demonstrating a zero risk of a malignant hyperthermia episode is not statistically possible, evidence in this large series suggests that the risk of an episode in these patients is extremely low and may be negligible. We suggest that anaesthetic triggering agents can be used safely in patients with normal in vitro contracture tests, and in their descendants.
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Emanuele, M. A., J. Tentler, L. Kirsteins, D. Reda, N. V. Emanuele, and A. M. Lawrence. "Anaesthesia with alphaxalone plus alphadolone acetate decreases serum concentrations of LH in castrated rats." Journal of Endocrinology 115, no. 2 (November 1987): 221–23. http://dx.doi.org/10.1677/joe.0.1150221.
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ABSTRACT Alphaxalone is considered the anaesthetic of choice in neuroendocrine reproductive studies in female rats, since it appears to have little, if any, effect on release of gonadotrophin-releasing hormone. There has been less study of the effects of this anaesthetic on the male reproductive neuroendocrine axis, however. Accordingly, the time-dependent effects of alphaxalone, as well as of urethane and ketamine, on the increased levels of LH in castrated rats were determined. Each anaesthetic was administered i.p. and each depressed LH levels significantly compared with those in castrated unanaesthetized rats killed by decapitation (controls). The effect of the anaesthetics was noted 15 min after administration and persisted at 30 and 60 min in animals anaesthetized with alphaxalone and urethane. Only in ketamine-anaesthetized animals did serum concentrations of LH finally rise to concentrations not significantly different from those in control rats. Thus alphaxalone, though useful in female neuroendocrine studies, is as profoundly disruptive as other anaesthetics on the male rat hypothalamic-pituitary reproductive unit. J. Endocr. (1987) 115, 221–223
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Harrison, G. A., and P. L. Byth. "A Survey of Fellows of the Faculty of Anaesthetists of the Royal Australasian College of Surgeons Endorsed in Intensive Care by Examination in the First 10 Years of Final Examinations in Intensive Care." Anaesthesia and Intensive Care 20, no. 2 (May 1992): 203–10. http://dx.doi.org/10.1177/0310057x9202000216.
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Fifty-nine of the 70 Fellows of the Faculty of Anaesthetists who had passed the Final Examination in Intensive Care including that of October 1989, responded to a questionnaire on the pattern of their intensive care and anaesthetic practice and their perception of the training and examination. Responses came predominantly from Fellows who had passed the examination more than two years previously. Forty-eight (81%) were practising intensive care at least 50% of the time and 51% had become Director or Deputy Director of an Intensive Care Unit. However, 51% maintained some anaesthetic practice. Although individuals had changed the intensive care/anaesthetic distribution of their practice, the group overall had not. With one exception all Fellows were practising in public hospitals but 26% in private hospitals also. Only eight had sought intensive care as their first vocational qualification. Training and examination were generally regarded favourably except for training in research methods and experience in internal medicine. The results suggest that the intensive care specialist is not likely to leave such practice in the long term, but there has been a reluctance to abandon altogether training and some subsequent practice in anaesthetics.
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Pavlovič, Andrej, Michaela Libiaková, Boris Bokor, Jana Jakšová, Ivan Petřík, Ondřej Novák, and František Baluška. "Anaesthesia with diethyl ether impairs jasmonate signalling in the carnivorous plant Venus flytrap (Dionaea muscipula)." Annals of Botany 125, no. 1 (November 30, 2019): 173–83. http://dx.doi.org/10.1093/aob/mcz177.
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Abstract Background and Aims General anaesthetics are compounds that induce loss of responsiveness to environmental stimuli in animals and humans. The primary site of action of general anaesthetics is the nervous system, where anaesthetics inhibit neuronal transmission. Although plants do not have neurons, they generate electrical signals in response to biotic and abiotic stresses. Here, we investigated the effect of the general volatile anaesthetic diethyl ether on the ability to sense potential prey or herbivore attacks in the carnivorous plant Venus flytrap (Dionaea muscipula). Methods We monitored trap movement, electrical signalling, phytohormone accumulation and gene expression in response to the mechanical stimulation of trigger hairs and wounding under diethyl ether treatment. Key Results Diethyl ether completely inhibited the generation of action potentials and trap closing reactions, which were easily and rapidly restored when the anaesthetic was removed. Diethyl ether also inhibited the later response: jasmonic acid (JA) accumulation and expression of JA-responsive genes (cysteine protease dionain and type I chitinase). However, external application of JA bypassed the inhibited action potentials and restored gene expression under diethyl ether anaesthesia, indicating that downstream reactions from JA are not inhibited. Conclusions The Venus flytrap cannot sense prey or a herbivore attack under diethyl ether treatment caused by inhibited action potentials, and the JA signalling pathway as a consequence.
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Voss, Logan J., and Jamie W. Sleigh. "A Metabolic Mechanism for Anaesthetic Suppression of Cortical Synaptic Function in Mouse Brain Slices—A Pilot Investigation." International Journal of Molecular Sciences 21, no. 13 (July 1, 2020): 4703. http://dx.doi.org/10.3390/ijms21134703.
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Regulation of synaptically located ionotropic receptors is thought to be the main mechanism by which anaesthetics cause unconsciousness. An alternative explanation, which has received much less attention, is that of primary anaesthetic disruption of brain metabolism via suppression of mitochondrial proteins. In this pilot study in mouse cortical slices, we investigated the effect of disrupting cellular metabolism on tissue oxygen handling and cortical population seizure-like event (SLE) activity, using the mitochondrial complex I inhibitor rotenone, and compared this to the effects of the general anaesthetics sevoflurane, propofol and ketamine. Rotenone caused an increase in tissue oxygen (98 mmHg to 157 mmHg (p < 0.01)) before any measurable change in SLE activity. Thereafter, tissue oxygen continued to increase and was accompanied by a significant and prolonged reduction in SLE root mean square (RMS) activity (baseline RMS of 1.7 to 0.7 µV, p < 0.001) and SLE frequency (baseline 4.2 to 0.4 events/min, p = 0.001). This temporal sequence of effects was replicated by all three anaesthetic drugs. In conclusion, anaesthetics with differing synaptic receptor mechanisms all effect changes in tissue oxygen handling and cortical network activity, consistent with a common inhibitory effect on mitochondrial function. The temporal sequence suggests that the observed synaptic depression—as seen in anaesthesia—may be secondary to a reduction in cellular metabolic capacity.
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Reid, W. D., C. Davies, P. D. Pare, and R. L. Pardy. "An effective combination of anaesthetics for 6-h experimentation in the golden Syrian hamster." Laboratory Animals 23, no. 2 (April 1, 1989): 156–62. http://dx.doi.org/10.1258/002367789780863592.
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The anaesthetics described for use in hamsters to date are suitable for the performance of short-term experimentation. However, an anaesthetic regimen was required which would provide a stable preparation for 6 h and hence, a suitable combination was developed. In the first set of experiments, the effect of anaesthetics (chloralose, urethane, and pentobarbital) were examined alone and in combination on arterial blood measurements. In the second set of experiments the effect of the combination of anaesthetics on arterial blood measurements and minute ventilation was examined for up to 6 h. Chloralose, urethane and pentobarbital when used alone in the hamster were considered inadequate for our needs. Chloralose did not produce adequate surgical anaesthesia whereas urethane and pentobarbital resulted in marked respiratory depression. Urethane also produced a trend towards metabolic acidosis. In contrast, the combination of agents resulted in surgical anaesthesia and the arterial blood measurements were adequate. Further, the use of the combination of anaesthetics in hamsters resulted in a stable preparation where arterial blood measurements and minute ventilation were maintained in a good range for up to 6 h. The combination of chloralose, urethane and sodium pentobarbital in hamsters should prove useful in long-term non-recovery experimentation which requires early surgical intervention, minimal respiratory depression and an even depth of anaesthesia.
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LAWRENCE, T. M., and V. V. DESAI. "Topical Anaesthesia to Reduce Pain Associated with Carpal Tunnel Surgery." Journal of Hand Surgery 27, no. 5 (October 2002): 462–64. http://dx.doi.org/10.1054/jhsb.2002.0823.
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This randomized, double-blinded study assessed the effectiveness of a topical anaesthetic, eutectic mixture of local anaesthetics (EMLA), in reducing pain associated with carpal tunnel release performed under local anaesthetic. Fifty-six patients undergoing carpal tunnel release under local anaesthetic were randomized into either EMLA ( n=29) or placebo ( n=27) groups. Visual analogue pain scores were obtained for needle insertion, injection of anaesthetic and surgery itself. Pain scores were significantly less for needle insertion ( P=0.001) and injection of anaesthetic ( P=0.0005). Scores related to surgery were also lower in the EMLA group, but this did not reach statistical significance.
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Nair, Anagha M., Vetriselvi Prabakaran, and Adhisivam Bethou. "Comparison of efficacy of eutectic mixture of local anaesthetic with amethocaine on pain during venipuncture among term neonates in a tertiary care hospital, India." International Journal of Contemporary Pediatrics 8, no. 4 (March 23, 2021): 727. http://dx.doi.org/10.18203/2349-3291.ijcp20211085.
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Background: Neonates are frequently subjected to painful procedures which can adversely affect future pain perception. Pain control measures during invasive procedures include non-pharmacological and pharmacological methods. One pharmacological intervention that can be used prior to a needle insertion procedure is application of a topical local anaesthetic to numb the skin. Topical anaesthetics prevent nerve impulse transmission, promoting skin analgesia by acting on the free dermal terminations. This study compares the efficacy of eutectic mixture of local anaesthetic with amethocaine on pain during venipuncture among term neonates. Methods: A randomized clinical trial was conducted with 70 term neonates who underwent venepuncture in neonatal intensive care unit of a tertiary care centre. A simple random sampling technique was used to enrol the neonates who met the inclusion criteria. Neonatal infant pain scale was used to collect the data. Descriptive and inferential statistics were used to analyse the data. frequency and percentage were used to describe the clinical and demographic variables of the study participants. The efficacy of topical local anaesthetics was analysed using independent student t test. Chi-square test was used to identify the association of level of pain with clinical and demographic characteristics of the neonate. The analysis was done with SPSS 21st version.Results: Compared to amethocaine group, in eutectic mixture of local anaesthetic (EMLA) group only lesser number of neonates experienced severe level of pain and mild to moderate level of pain. Though mean pain score in EMLA group (3.457±1.633) was lesser than amethocaine group (4.000±1.514) it was not significant (p=0.347).Conclusions: The study revealed the efficacy of topical anaesthetics in relieving pain in term neonates during venipuncture.
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&NA;. "Anaesthetics." Reactions Weekly &NA;, no. 1129 (November 2006): 5. http://dx.doi.org/10.2165/00128415-200611290-00011.
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&NA;. "Anaesthetics." Reactions Weekly &NA;, no. 1131 (December 2006): 7. http://dx.doi.org/10.2165/00128415-200611310-00014.
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&NA;. "Anaesthetics." Reactions Weekly &NA;, no. 1133 (January 2007): 5. http://dx.doi.org/10.2165/00128415-200711330-00016.
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&NA;. "Anaesthetics." Reactions Weekly &NA;, no. 1135 (January 2007): 6. http://dx.doi.org/10.2165/00128415-200711350-00020.
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&NA;. "Anaesthetics." Reactions Weekly &NA;, no. 1146-1147 (April 2007): 8. http://dx.doi.org/10.2165/00128415-200711460-00026.
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